Women and men share largely the same risk factors for cardiovascular disease. This is evidenced by a large-scale global study involving researchers from the University of Gothenburg.
The study, published in The Lancet, included participants in both high-income and low- and middle-income countries. These are more susceptible to cardiovascular disease. The basis is from the PURE population study (Prospective Study of Urban Rural Epidemiology).
The study included 155,724 individuals in 21 countries on five continents. Participants were aged 35-70 years and had no history of cardiovascular disease when they were included. During the follow-up period of an average of ten years, all cases of fatal cardiovascular disease, heart attack, stroke and heart failure were recorded.
The risk factors studied were metabolic (eg hypertension, obesity, diabetes), behavioral (tobacco smoking and diet) and psychosocial (economic status, depression) risk factors.
Gender and income No catchment
Metabolic risk factors were similar in women and men, except for higher levels of LDL cholesterol, where the association with cardiovascular disease was stronger in men. However, this particular finding must be confirmed in more studies, the researchers say.
Depressive symptoms were also a higher risk factor for cardiovascular disease in men than in women. In contrast, the link between poor nutrition and cardiovascular disease was stronger in women. Smoking was significantly more common among men, but as a risk factor smoking was poorer for women.
Overall, the researchers report that women and men have broadly similar risk factors for cardiovascular disease, regardless of the country’s income level, underscoring the importance that disease prevention strategies should be the same.
The similarities are greater than the differences
The lower risk of cardiovascular disease, especially myocardial infarction, in the group of women as a whole could be explained by the increased tolerance of risk factors for younger women. Estrogen makes their vessel walls softer and affects the liver’s ability to take care of bad cholesterol.
In the group of women in the study (90,934 individuals), 5.0 cases of stroke, heart attack or cardiovascular disease were recorded per 1,000 people per year. The corresponding number in the group of men (64,790 individuals) was 8.2 cases.
Annika Rosengren, Professor of Medicine at the University of Gothenburg’s Sahlgrenska Academy, is the second author of the study and responsible for the Swedish part of the PURE population study, which consists of just over 4,000 individuals in Gothenburg and Skaraburg.
– When it comes to cardiovascular disease in men and women, the similarities in risk factors are much greater than the differences, but men are more sensitive to levels of harmful cholesterol, and this is in line with the fact that men develop pathological changes in the body. Coronary arteries at a younger age than women and their heart attack begins significantly earlier. She says the differences with respect to early stroke are less clear, which we’ve also seen in other studies.
Title: Metabolic, Behavioral, Psychosocial, and Cardiovascular Risk Factors in Women Compared to Men in 21 High-, Middle- and Low-Income Countries: PURE Study Analysis, https://doi.org/10.1016/S0140-6736(22)01441-6
Contact: Annika Rosengren, Tel. 0709 60 36 74, email [email protected]
picture: Annika Rosengren (Photo: Cecilia Hedstrom)
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Sahlgrenska Academy is part of the University of Gothenburg Medical School Education and research in medicine, dentistry and healthcare sciences, www.gu.se/sahlgrenska-akademin
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